Before the advent of networked systems and computers, medical patient workflow and billing was a manual process. Doctors, nurses, and receptionists used paper-based records to keep track of which tests a patient had undergone, what the patient's insurance would and would not cover, and how claims for healthcare items and/or services would be settled. As computers became more widely utilized, many medical practitioners used computers for electronic record keeping and billing statement generation.
With many medical practices, the number of patients that the practice serves fluctuates from day to day or season to season. As a result, the number and/or complexity of transactions that a medical practice management system processes for a given time period also fluctuates. These transactions, however, are important to the proper functioning of a medical practice management system. Examples of transactions include patient eligibility for a payment with respect to healthcare items and/or services, referral verification and approval, and claims processing transactions. When interacting with third-party payors such as insurance companies, it is often difficult to determine if the payors' processing system can handle a given volume of data that needs to be processed for the medical practice management system to function.